Related Experiment Video
Updated: Aug 11, 2026
CO2-Lasertonsillotomy Under Local Anesthesia in Adults
Published on: November 6, 2019
Depressive symptoms in children after tonsillectomy
K Papakostas1, D Moraitis, J Lancaster
1Department of Pediatric Otolaryngology, Royal Liverpool Children's Hospital, Alder Hey, Liverpool, UK.
Insights
Post-tonsillectomy depression in children is more common than previously thought, affecting 17% of patients. While symptoms usually resolve spontaneously, psychological preparation is recommended.
Area of Science:
- Pediatric Otolaryngology
- Child Psychology
- Surgical Outcomes
Background:
- Severe depression cases post-tonsillectomy suggest psychological trauma.
- The prevalence of depressive symptoms after pediatric tonsillectomy is not well-established.
Purpose of the Study:
- To quantify the prevalence of depressive symptoms in children following tonsillectomy.
- To utilize current diagnostic methods for assessing post-tonsillectomy depression.
Main Methods:
- Prospective study of 159 children undergoing tonsillectomy at a Pediatric University Hospital.
- Postoperative questionnaires based on International Classification of Diseases, 10th Revision (ICD-10) criteria for depression.
- Telephone interviews for confirmed depressive episodes at 3 months post-operation.
Main Results:
- 17% (15 of 89 returned questionnaires) of children aged 4-16 developed depressive symptomatology.
- This prevalence is higher than the general child population (4%) and other pediatric hospital populations (10-20%).
- No persistent depressive symptoms were observed at the 3-month follow-up.
Conclusions:
- Post-tonsillectomy morbidity can include depressive symptoms that typically resolve spontaneously.
- Otolaryngologists, nurses, and physicians need high suspicion for early diagnosis of persistent cases.
- Structured preoperative psychological preparation for pediatric patients is emphasized.
Objective:
Several cases of severe depression after tonsillectomy have been described in children, indicating psychological trauma after surgery and hospitalization. The actual prevalence of depressive symptoms after tonsillectomy is unknown and possibly underestimated. This study aims to quantify this problem by employing current diagnostic methods.
Methods:
This is a prospective study of 159 children who underwent tonsillectomy in a major Pediatric University Hospital. All patients stayed in the hospital overnight. Parents were sent questionnaires based on diagnostic criteria for depression (ICD-10) 3 weeks postoperatively. Whenever the criteria for a depressive episode were met, a telephone interview with the parents followed 3 months after the operation.
Results:
Some 89 questionnaires were returned (56%), revealing that 15 patients (17%), 4-16 years old, developed depressive symptomatology compared with a 4% prevalence of depression in the general child population and 10-20% in the pediatric hospital populations. No children had persisting symptoms 3 months later.
Conclusions:
These results suggest that post-tonsillectomy morbidity can occasionally manifest with depressive symptoms, usually resolving spontaneously. A high index of suspicion is required by the otolaryngologist, nurses and primary care physician for early diagnosis and referral of persisting cases to a specialist. Emphasis is given to a structured preoperative psychological preparation of pediatric patients.
Related Concept Videos
01:23Chronic Pharyngitis
Etiology
It often arises from persistent viral or bacterial infections affecting sinuses and tonsils.
Additional contributing factors include inadequate dental hygiene, mouth breathing, recurring tonsillitis, allergic rhinitis, laryngopharyngeal reflux, and exposure to smoke, chemicals, and other environmental pollutants. Allergic reactions to pollen, mold, and pet dander, chronic cough, excessive voice usage,...
01:30Tonsillitis I: Introduction
Etiology
Three primary contributing factors have been identified.
01:26Tonsillitis II: Management
01:29Suctioning the Nasopharyngeal Airway
Equipment Required
01:27Depressive Disorders: MDD and Dysthymia
01:30Negative and Cognitive Symptoms of Schizophrenia
Negative Symptoms
Negative symptoms of schizophrenia manifest as deficits in normal emotional and behavioral functioning, profoundly impacting daily life. Individuals with schizophrenia often display a flat affect, characterized by a near-total absence of emotional expression,...